Obstetric violence: mother uses trauma to help others

Pamela Madonsela spoke with a Cape Town doula who suffered obstetrical abuse before embarking on her journey to provide a better birthing experience for other mums.

“If I had known at the time what obstetrical violence was, I would have acted. Or better yet, I would have found someone like a birth doula to support me,” explained Noloyiso Williams, who had a traumatic experience giving birth to her first child.

She became pregnant as a teenager and remembers what turned into a few horrific hours. It all started with a throbbing pain in her stomach.

Here is his story:

“I was just lying there until the pain got too bad to ignore, so I decided to go to the bathroom because I thought I had a bug in my stomach, but I didn’t know it was. was a pain of labor.

I finally had to wake up my mom and she started freaking out, asking me all kinds of questions. “How long have you been in pain? Have you seen blood on your underwear? Has your water broken? I replied ‘huh’ because I had no idea what she was talking about. But apparently my waters had broken two hours earlier when I thought I had pissed myself.

Hurry up

My mother managed to reach my father and arranged transportation to take me to the hospital. When we arrived, my mother had come to get a nurse to take care of me. She immediately checked my hospital book, which became a problem because the hospital was “outside” my community. She and another nurse discussed this minor detail as my pain worsened.

I cried out in pain calling for my mother. It was only then that the other nurse noticed that I had blood running down my leg. They organized a wheelchair for me and took me to the labor room. They did cervical checks and set up a fetal heart monitor. That’s when they noticed there was hardly any fetal heartbeat, which meant my baby was in distress. They let my mother know that they were booking an emergency caesarean and needed her approval since I was underage. She signed the papers and I was rushed to the theater under anesthesia. My son was born weighing 3.5kg and was rushed to the NICU.

What is obstetrical violence?

Nonkululeko Mbuli, communications and advocacy strategist at Embrace, said obstetric violence refers to the abuse of pregnant women and birth attendants who access care at a health facility during pregnancy and childbirth. She added that this is a violation of their reproductive health rights and basic human rights.

“This normalized state of violence against women and people giving birth leads to physical or psychological harm and has a lasting negative impact on maternal health and early childhood development,” Mbule said.

Embrace “is a national movement that promotes a connected and thriving early motherhood for every new mother in South Africa. Its vision is based on the understanding that an empowered and embraced mother raises a thriving child.

Mbuli says this type of violence occurs during pregnancy, childbirth and postpartum.

She said violence in care settings takes many forms, such as:

  • physical violence
  • verbal violence
  • structural violence
  • emotional abuse
  • non-consensual procedures, sexual abuse
  • negligence and breaches of professional standards
  • medically unnecessary interventions
  • lack of accountability and complaint mechanisms
  • stigma and discrimination
  • refusal or delay of treatment
  • lack of or unequal access to care (including comprehensive abortion care)
  • health system conditions and constraints;
  • and other types of violence committed against women.

“I’m crying at the top of my lungs”

Williams detailed her nightmarish experience.

“As the doctor sewed me up, the anesthesia wore off and I could feel everything that was going on there. I screamed at the top of my lungs until they gave me another dose which left me knocked me out. When I woke up in the recovery room, they explained to me that they were in a rush because of the urgency of the baby and that they had underestimated the amount of anesthetic they administered to me,” she explained.

She said the birth of her son was so traumatic that she considered terminating her second pregnancy.

“But luckily God had other plans for me. I kept the baby after a series of interventions and counseling, and it made me stronger and the woman I am today. I am a proud mother of three and a proud birth attendant,” Williams said.

Obstetric violence – an act of GBV

According to Sheena Swemmer of the Center for Applied Legal Studies at the University of the Witwatersrand, South Africa demands that appropriate legislation and policy be put in place. The blatant acts associated with obstetric violence target a vulnerable group in our society and are discriminatory, which must be recognized. Once this is the case, the law can then consider obstetric violence as an act of gender-based violence (GBV) rather than what we currently have, which is that obstetric violence is considered medical malpractice .

Mbuli says there is currently no specific policy that addresses issues of obstetric violence, which is why Embrace aims to educate women and those who give birth about obstetric violence and their rights.

“We organize community conversations and organize spaces where women who have experienced obstetrical violence can share their stories. As a movement for motherhood, we are advocating for obstetric violence to be on the national agenda and mobilizing key stakeholders to build support for victims of obstetric violence and enable collective action,” added Mbuli.

“Currently, we don’t have a specific piece of legislation that addresses issues of obstetric violence, and we need to consider improving the legislation to start addressing this issue. Obstetric violence is a global problem. In countries like Argentina, Mexico and Venezuela, obstetric violence has been recognized as a form of GBV. We would like obstetric violence to be included in the National Strategic Plan on Gender Based Violence and Femicide,” says Mbuli.

Williams currently works at a Flourish franchise, where she trains expectant mothers and doulas. Her experience inspired her to do her part in the community.

OV Survivor reaches out

“My birthing experience is the reason I became so passionate about working with pregnant women. I became more educated as a mother and learned about birth norms. That’s when I realized that as women of color, our voices are often undervalued and discriminated against, and we also lack access to resources and quality care,” Williams said.

She continued: Throughout history, women have always helped women give birth. Today, childbirth tends to become lonelier and more psychologically stressful for the mother. Williams referred to Michel Odent, a leading French childbirth specialist.

You don’t have to be born into the UNKNOWN. You don’t have to wish you had done things differently. You are the MASTER of your destiny. It is you who achieve the birth you want and although it is a mystery, you can demystify the birth. “To change the world, we must first change the way babies are born.

A need for education

Mbuli said there was a need for ongoing evidence-based clinical training in maternity care and ongoing training of health workers on the rights-based approach to sexual and reproductive health care and obstetric violence.

“Everyone who is pregnant or giving birth has the right to dignified and respectful health care throughout pregnancy and to be free from violence and discrimination during childbirth. Obstetric violence is a form of gender-based violence that reflects the broader societal devaluation of women and girls in South Africa and the normalization of violence against them. Together with other partners working to end VO, we call on the Minister of Health and the Minister for Women, Youth and People with Disabilities to develop and cost a measurable and time-bound plan to transform maternal health resources to prevent neglect. and abuses due to lack of personnel and resources urgently,” Mbuli said.

In conclusion, Williams says people giving birth don’t have to agree with their healthcare providers to meet their care expectations.

“Changing the landscape of the conversation between health care providers and people giving birth is essential, and birth attendants play a central role in this process. They can help you understand what’s going on during pregnancy, labor, and postpartum. This includes explanations of procedures, and we can bring sacredness and ceremony to the most mundane activities and make them the most precious. These special moments make me pinch myself, I can’t believe I get the chance to create these spaces to live in,” she added.

Mbuli said women and girls who have suffered VO and their families could sue, but it can be very costly and take years. The Office of the Health Ombudsman has a freephone line on 080 911 6472. – Health-e News

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